Relationships between worry about dying in patients with advanced cancer and their illness understanding, treatment preferences, and advance care planning.

Rodenbach, Rachel; Althouse, Andrew D.; Smith, Thomas J.; White, Douglas B.; Chu, Edward; Bakitas, Marie; Schenker, Yael; Arnold, Robert M.

doi:10.1200/jco.2020.38.15_suppl.12080

Cited by 3 publications

(3 citation statements)

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“…The mean ± SD of people's age was 62.04 ± 6.44. Most of the articles were published to the United States included (n = 14 cases) (29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42). followed by China (n = 2 cases) (43,44), and South Korea (n = 1) (45), Canada (n = 1) (46), Israel (n = 1) (47), Germany (n = 1) (48) and Taiwan (n = 1) (49).…”

Section: Resultsmentioning

confidence: 99%

Factors related to advance care planning from the perspectives of cancer patients: a systematic review

Golmohammadi

Ebadi

Ashrafizadeh

et al. 2023

Preprint

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Introduction: Advance care planning (ACP) has recently been considered as an important component of palliative care for patients with advanced cancer and is a process through which patients express their preferences and goals regarding end-of-life care and make decisions regarding their future treatment priorities. Therefore, the present systematic review investigated the factors related to ACP from the perspective of cancer patients. Methods: A systematic review study was searched in four scientific databases: PubMed, Medline, Scopus, Web of Science, and ProQuest using with related keywords and without date restrictions. The quality of the studies was assessed using the Hawker criterion. The research papers were analyzed as directed content analysis based on the theory of planned behavior. Results: Out of 5900 research papers found, 21 were included in the study. The perspectives of 9061 cancer patients were investigated, of whom 4347 were men and 4714 were women. The mean ± SD of the patients' age was 62.04 ±6.44. According to TPB, factors affecting ACP were categorized into four categories, including attitude, subjective norm, perceived behavioral control, and external factors affecting the model. The attitude category includes two subcategories: "Lack of knowledge of the ACP concept " and " Previous experience of the disease", the subjective norm category includes three subcategories: "Social support and interaction with family", "Respecting the patient's wishes" and "Prioritizing EOL care". Also, the category of perceived control behavior was categorized into three sub-categories: "Decision-making", "Participation in life activities" and " Support from healthcare system ", as well as external factors affecting the model, including "demographic characteristics". Conclusion: The studies indicate that attention to EOL care and the wishes of patients regarding receiving medical care and preservation of human dignity, the importance of facilitating open communication between patients and their families, and different perspectives on providing information, communicating bad news and making decisions require culturally sensitive approaches. Finally, the training of cancer care professionals in the PC practice, promoting the participation of health care professionals in ACP activities and creating an ACP-positive attitude should be strongly encouraged.

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Section: Resultsmentioning

confidence: 99%

Factors related to advance care planning from the perspectives of cancer patients: a systematic review

Golmohammadi

Ebadi

Ashrafizadeh

et al. 2023

Preprint

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“…Indeed, patients who worry about dying are more likely to want life-prolonging treatment and less likely to engage in advance care planning. 71,75 The other profile seems characterized by patients' coping style. For example, patients with optimistic coping may see opportunities for control by fighting the disease.…”

Section: Discussionmentioning

confidence: 99%

Attitudes Toward Striving for Quality and Length of Life Among Patients With Advanced Cancer and a Poor Prognosis

Velden

Laarhoven

Nieuwkerk

et al. 2022

JCO Oncology Practice

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PURPOSE: When deliberating palliative cancer treatment, insight into patients' attitudes toward striving for quality of life (QL) and length of life (LL) may facilitate goal-concordant care. We investigated the (1) attitudes of patients with advanced cancer toward striving for QL and/or LL and whether these change over time, and (2) characteristics associated with these attitudes (over time). METHODS: We performed a secondary analysis of a randomized controlled trial on improving shared decision making (SDM), without differentiation between intervention arms. Patients (n = 173) with advanced cancer, a median life expectancy of < 12 months without anticancer treatment, and a median survival benefit of < 6 months from systemic therapy were included in seven Dutch hospitals. We used audio-recorded consultations and surveys at baseline (T0), shortly after the consultation (T2), at 3 and 6 months (T3 and T4). Primary outcomes were patients' attitudes toward striving for QL and LL (Quality Quantity Questionnaire; T2, T3, and T4). RESULTS: Overall, patients' attitudes toward striving for QL became less positive over 6 months ( P < .01); attitudes toward striving for LL did not change on group level. Studying individual patients, 76% showed changes in their attitudes toward striving for QL and/or LL at some point during the study, which occurred in various directions. More helplessness/hopelessness ( P < .001), less fighting spirit ( P < .05), less state anxiety ( P < .001), and more observed SDM ( P < .05) related to more positive attitudes toward striving for QL. Lower education, less helplessness/hopelessness, more fighting spirit, and more state anxiety ( P < .001) related to more positive attitudes toward striving for LL. CONCLUSION: Oncologists may explore patients' attitudes toward striving for QL and LL repeatedly and address patients' coping style and emotions during SDM to facilitate goal-concordant care throughout the last phase of life.

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“…In summary, we explored accuracy of curability expectations in patients with GI cancers regardless of stage and identified lower accuracy rates among those with metastatic disease, unresectable disease, and early‐stage patients who did not receive adjuvant chemotherapy. Additional studies will evaluate more disease types and the associations of distress (physical, emotional, spiritual), including worry about death and dying, 39 on patient expectations. Accurate illness and treatment understanding by patients can support them and their care team to align around the goals and plans for oncologic care.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of curability expectations in patients with gastrointestinal cancers

et al. 2022

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Background Assessment of illness and treatment understanding among cancer patients has largely focused on those with advanced disease. Less is known about patient expectations at earlier stages of cancer and potential modifiers of accurate understanding. Methods We assessed accuracy of cure expectations in patients across all stages with gastrointestinal (GI) cancers. Accuracy was determined by independent reviews of patient health records by oncologists on the investigative team. Impact on cure accuracy of selected clinical variables and health‐information preferences was analyzed. Results Hundred and thirty five patients were included for analysis, with 100% interrater agreement for accuracy between oncologist reviewers. Sixety five patients (48%) had accurate cure expectations from their cancer treatment. Accuracy was lower in Stage IV versus Stage I–III disease (35% vs. 63%, p < 0.01), lower in unresectable versus resectable disease (35% vs. 67%, p < 0.01), and higher in patients with early‐stage disease who received adjuvant chemotherapy versus those who did not (78% vs. 53%, p = 0.04). Accuracy did not differ by health‐information preferences and remained stable over time. Of 63 patients who died, baseline accuracy differed by location of death ( p = 0.03), with greater accuracy in those who died with home hospice (56%). Accuracy was lower in those who were hospitalized in the last 30 days of life versus those who were not (25% vs. 59%, p = 0.01). Conclusions Inaccurate cure expectations are prevalent across all stages of GI cancers, but particularly among those with metastatic or unresectable disease. High‐quality, iterative communication strategies may facilitate patient illness and treatment understanding throughout the disease course.

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Relationships between worry about dying in patients with advanced cancer and their illness understanding, treatment preferences, and advance care planning.

Cited by 3 publications

References 0 publications

Factors related to advance care planning from the perspectives of cancer patients: a systematic review

Factors related to advance care planning from the perspectives of cancer patients: a systematic review

Attitudes Toward Striving for Quality and Length of Life Among Patients With Advanced Cancer and a Poor Prognosis

Accuracy of curability expectations in patients with gastrointestinal cancers

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